STORY ARCHIVE

“Don’t Die Young” Episode 6 – “Brain”

Dr Alice Roberts delves deep into the body’s most complex organ – the brain – and discovers how it can be ‘tricked’ into seeing things which don’t exist, and how it can be trained to improve its memory function.

Rugby fanatic and primary school teacher Sean Gilbertson has trouble remembering the names of the 27 pupils in his class; he thinks it’s down to the 40 separate concussions he has received playing his beloved sport. He has now been told to quit rugby – or risk damaging his brain permanently.

Alice invites Sean to her lab to find out more about the intricate workings of the brain, but will his newly gained knowledge persuade him to find a gentler sport?

They hope to learn more about the brain’s remarkable powers of memory courtesy of Dominic O’Brien – eight times world memory champion – who can recite the correct order of 54 packs of playing cards after seeing them just once.

Both Dominic and Sean have a brain scan which reveals how differently brains can work.

Alice also discovers how sleep deprivation causes the brain to send the body hunger messages which lead her to eat more. She also sets out to discover whether getting a good night’s sleep can help people lose weight.

TRANSCRIPT

Today, I'm going to be looking at the most complex and mysterious organ.The human brain. I'll find out how the brain can be tricked and trained to improve its function. I'm going to see for myself what my own brain looks like. And we'll be following a life-saving operation to remove a blood clot in the brain.

The brain creates who we are. It's constantly processing masses of information so we can make sense of the world around us. It plans and guides every move we make and it's the seat of our emotions and personality.

I'm meeting up with neuroscientist Dr Beau Lotto who's investigating how our brains have evolved to make sense of the world. We call it perception. But how exactly does it work?

Optical illusions provide us with fascinating clues about how our brains process the flood of images entering our eyes.

So this one, whether he's Tweedle Dum or Tweedle Dee, I'm not sure but he looks to me like he's pretty rounded, fleshed out.

Dr Beau Lotto Like he's coming out at you.

Dr Alice Roberts Yeah.

In fact, clever lighting is fooling the brain into thinking that both figures are protruding. The left-hand figure is actually concave.

Dr Beau Lotto What the brain has to do, it has to construct what it sees from its experience. The only way it can do that is by shaping itself according to the trial-and-error process of interacting with the world.

Dr Alice Roberts So, in reality, everything we see is an illusion. But the brain's ability to interpret all the information it's bombarded with is crucial for our survival.

The brain is an exceptional organ but like all the others, it needs looking after and diet and lifestyle have a big impact on it just as on any organ. But what makes for a brain-friendly lifestyle?

27-year-old Sean Gilbertson is keen to boost his brain power. Sean is a busy teacher at Llanelltyd Primary School in South Wales.

Sean It is the best job for me. I wouldn't swap it for anything. You can influence young people's lives. You can...what I do today could shape a young person's life for the rest of their life.

Dr Alice Roberts Sean is using his brain all day long. But he's worried that his memory is letting him down.

Sean Right. Megan...Keila...

Dr Alice Roberts He thinks his memory problems are a direct result of his other great passion - sport. As well as being PE coordinator for the school, he regularly plays for his local rugby team.

We've come to meet Sean. It's actually quite difficult 'cause he doesn't have much free time. ecause all the time e's not teaching, s pretty much taken up with this and I think rugby is actually his first love. His passion for rugby means that physically, he's superfit. But there are some downsides to this as well, aren't there?

Sean Yeah, one or two. I'm quite susceptible to get knocked out quite often. So yeah, I get quite a lot of concussions.

Dr Alice Roberts How often does it happen?

Sean I would say about 3-4 times a year or just roughly that.

Dr Alice Roberts Really?

Sean Yeah. About 20-30 odd in the last 10 years.First time I got knocked out I was 17. Ever since then, I've been getting concussions regularly, to be honest.We'll have a look at the brain in a bit more detail and in particular, memory,'cause you're worried about your memory.

Sean Yes. It's not the best.

Dr Alice Roberts It's lucky I made it tonight,to be honest. I actually remembered. But yeah, my memory is not… my short term memory's terrible. My kids in my class in school, they constantly leave notes to me or messages on the board -"You've got to meet my mum tonight". “Oh, you know you got to remind me, Ben.” I'm constantly saying Ross when I meant Thomas.

Dr Alice Roberts Before we see if if we do anything to improve Sean's memory,let's take a closer look at the body's most sophisticated organ. Trevor, I'm just sketching the boundaries of the brain at the momentbefore we start filling in some of the details.

We humans have big brains. Most of it is made up of the cortex which forms the outer rind. It's folded in on itself to pack in more nerve cells.I suppose it's like writing something on a very big sheet of paper and then crumpling it up. You still got the information there but you've crumpled it into a smaller size.

The brain is divided into four lobes on each side and each of them has a different function. So, this is almost done now. So, we've got Trevor's brain in all it's splendour and you can see the different lobes. This lobe here is the frontal lobe of the brain.

That's really where your personality is, where your emotions are. That sort of thing. The parietal lobe on the side of the head here, that's where the brain receives the sensations from your body. Right at the back of the head here, the occipital lobe, is to do with the vision. So, this is receiving signals from the eyes. And this lobe here is the temporal lobe which is to do with hearing and smell and deep within it, memory as well.

I've invited Sean along to the lab to find out a bit more about the contents of his skull.

So, Sean, this is a horse's brain. It's quite a bit smaller than a human brain. But it's got all the same bits that a human brain has got. It's just it hasn't got as much cerebral cortex. So, horses aren't quite as clever as us.

Do you want to pick that up and have a feel of it? It's a very odd texture.

Sean Ugh!

Dr Alice Roberts It's quite floppy, isn't it?

Sean Yes, it's...like a bag of mince.

Dr Alice Roberts Very, very strange indeed. It's almost like a sort of blancmangey texture,when it's fresh like this. If you look at the top, really all you see is the cortex. If you turn it over, you see a few more things. That's actually part of the optic nerve, just there,that comes from the back of the eye. So that's bringing all the information from the eyes back to the brain.

Sean So what is the difference between the grey matter and the white matter?

Dr Alice Roberts It's different parts of nerve cells, essentially. So, on the outside, we've got the little bodies of the nerve cells with their nuclei and they're all sitting in the cortex and then in the white matter,what you've got are the little processors which form the wiring of the brain as it were. What you're looking at there is billions and billions of neurons and billions and billions of connections between them.

At the back of the brain is a tree-shaped structure. The cerebellum.

Sean So what does the cerebellum actually do?

Dr Alice Roberts It's really important in controlling your posture, and balance, and it also coordinates all your muscles as well. It's going to be important to you in your running on the field and tackling and all that sort of thing.

It's strange to think that this physical object holds our minds and contains all our memories.

Magician I'm going to give you 15 seconds.

Woman in the street OK.

Magician I'm Look at these items. I want you to remember them in order.

Woman in the street I shan't remember.

Magician I'll cover it back over and then I want you to relay it back to me. Here we go. Let's see how you did.

Woman in the street Teat, dinosaur.

Girls in the street A thermometer,Glasses.

Man in the street #1 Temperature thingy, glasses,

Woman in the street A strainer.

Magician You remember the order of them?

Girls in the street Screwdriver,Tomato,

Man in the street #2 I lost the order 'cause I did it all out of order.

Man in the street #1 A pink tomato or something like that.

Woman in the street And I really think that's it.

Magician You got six. Look, the next one...

Man in the street #1 That's all I remember now. (Laughs)

Dr Alice Roberts Most people can only remember 7-8 objects in a sequence. Dominic O'Brien can remember 54 decks of shuffled cards after seeing them just once. He's won the world memory championship eight times. Sean and I have met up with him to see if he's got any tips for how Sean can improve his memory. But first, we test him out on a pack of shuffled cards.

Right, then. So, what do you want me to do? Just...?

Dominic I'll go through the deck and you check them as I go through.

Dr Alice Roberts OK.

Dominic I'll close my eyes.

Dr Alice Roberts Alright.

Dominic Right, so it starts with the seven of diamonds,then the jack of hearts,then the nine of clubs, two of clubs, is that right?

Dr Alice Roberts Yeah.

Dominic Five of hearts, ten of clubs, seven of clubs, six of spades,three of diamonds, nine of hearts, the four of clubs, ace of spades, eight of diamonds, then the two of spades, and then the ten of diamonds and four of diamonds.

Sean Oh! Wow!

Dr Alice Roberts Well, I'm impressed.Do you want to have a go, Sean?

Sean Um...Two of diamonds.That's all I can remember.

Dr Alice Roberts But what exactly is memory? Brain activity consists of electrical signals passing along neurons and the billions of neurons in the brain also talk to each other at their connections or synapses. Getting the same signal over again increases the strength of the response and this is the basis of memory and learning. I want to find out if there's something specialgoing on in Dominic's brain which accounts for his amazing memory.

Dominic and I have come to Cardiff University Brain Scanner unit. We're going to be comparing which areas of their brains are activated when they're given a simple memory test.

While they're under the scanner, Dr Ella Hinton will show them a series of descriptions. They then have to indicate whether various statements are true or false.

So, Sean is in the MRI machine actually performing the memory taskand at the same time, his brain is being scanned by the MRI machine incredibly quickly, collecting massive amounts of data that can then be analysed to showwhich parts of his brain are active as he's remembering.

With the scans finished,it's time for the results. So, Ella. Have you got the results of the test back?

Dr Ella Hinton Yeah.

Dr Alice Roberts How did they do?

Dr Ella Hinton Well, I have to say they both did really well. So, Sean, you got 80% overall on the memory test.

Sean Never. All guessed.

Dr Ella Hinton OK. And Dominic, you did reallywell. You got 100%

Dominic Oh, did I? Oh.

Dr Alice Roberts Wow! That's fantastic. So, how did you do it?

Dominic I was using spatial strategy. So, for example, one of the questions was, Sonia is taller than Grace. So, I imagined Sonia, somebody I know opening a dormer window and looking down at Grace who's opening the first floor window.They're looking at each other like that. Then the next bit of information would come along. But Wendy's taller than Sonia. So, she'd have to be on the chimney talking to Sonia. So, I'm building up the information. I'm using mnemonics as well.

Dr Alice Roberts What about you, Sean? Were there any strategies you were using to try to remember the information?

Sean Basically, I was trying to remember the information. But there was one section was all people I knew so I could visualise them that way.

Dr Alice Roberts Yeah.

Sean Only a couple. The rest, I tried to remember as much as I could.

Dr Alice Roberts So, we've got two very differentmemory strategies going on there. Is that reflected at all in the scans?

Dr Ella Hinton I think it might be, yes.Here, if we look at Dominic's activity, we can see in the left prefrontal cortex areas activated that are known to be associated with working memory and reasoning. So, that fits with the task.Also which is interesting from what you've said about the strategy you were using, was this area here and it's known for processing visual objects.So,interpreting the visual world.

Dr Alice Roberts So, when Dominic's thinking abut these people and various parts of buildings, it's lighting up that bit of the brain?

Dr Ella Hinton Yes, it’s lighting up that bit of the brain.

Dr Alice Roberts When we look at Sean's scan, there's no activity in this part of the brain. The key to Dominic's exceptional memory seems to be his technique of turning what he needs to remember into an imaginary journey.

So Dominic, do you think your technique,this visualisation technique, could actually help Sean to,for instance,remember the names of the schoolkidsin his class?

Dominic Definitely. This is one of the things I have to do - memorise audiences when we do after-dinners and there could be 100-150 people there. I couldn't do it unless I was using the journey method. I'll teach youthe journey method.

Dr Alice Roberts So, there are techniques we can use to improve our memories. But how can we go about preventing memory loss?

Just as physical activity is good for your whole body, mental activity is good for your brain. It's the old 'Use it or lose it' principle. There are loads of these brain trainers on the market at the moment. Some of them, brain teasers in books and some of them,computer games. There's no hard evidence to show that any of these do boost your brain power. But nonetheless, there is evidence to show that keeping mentally active protects against memory loss and reduces the risk of Alzheimer's. And that could be anything from stimulating conversation, keeping socially active, reading -that sort of thing. You don't need to spend money on all of these.

And there are other ways we can make the best of our brains. Having a good night's sleep,for example.It's something that Sean's not getting at the moment.

Sean Earliest I go to bed in the week is probably 12 o'clock, 12:30.The very earliest and I'm up pretty knackered the next day.

Dr Alice Roberts Just like Sean, I often find it difficult to get the recommended seven to eight hours of sleep a night. But now I'm going to find out what happens when I deliberately deprive myself of sleep.

I'm off to see a colleague of mine at Bristol University, sleep expert Dr Shahrad Taheri,who's going to be running an experiment.To begin with, he gives me a simple cognitive test to see how I do on my normal sleep quota.

86 minus 7 is 79.

72...65...

fifty...eight...ha ha ha!

Then it's off to the hotel where I'll be based while I cut down on my shuteye. Over the next 48 hours, I'll be getting just 4 hours sleep a night and I'm not looking forward to it. It reminds me of my nights on call. Oh! Right, it's two o'clock, nearly and I'm going to wake myself up at six. I'm filling in my sleep diary and I'm also wearing this watch-like device which is actually going to measure my activity during the day and also at night, while I'm asleep.

The following morning, the lack of sleep is already having an effect. I'm feeling quite tired, obviously,'cause I only had four hours sleep. I really, really want a coffee and I'm not allowed to drink anything with caffeine in it. So, I've got green tea instead. Which isn't going to do the job, I don't think.The day drags on,and by the second night,I can hardly keep my eyes open. Reading research papers and trying to write something sensible just isn't happening.I'm trying to work, but I think I'm going to have to redo everything I've done tonight'cause I'm too tired and I'm just making loads of mistakes. I've been making mistakes all day as well. I've been doing stupid things like getting wrong keys out to open doors and I've still got another night of only four hours of sleep. Oh, God.It's the morning of Day Two and I'm feeling wretched. I can't wait for it all to be over.

...minus 7 is 30...

Back at Dr Taheri's it's time to discover how I fared.12 seconds?! Ha ha ha!

I'm fine with simple subtraction but what happens with the harder sums?

Dr Shahrad Taheri Last time the test took you about 11.5 minutes, and what's so interesting this time is,the test took you 15.5 minutes.

Dr Alice Roberts Really?

Dr Shahrad Taheri So, you're about four minuteslower than you were before.

Dr Alice Roberts I didn't feel as if it went any slower.

Dr Shahrad Taheri What was more remarkable was that last time you made only two errors and this time you made six errors

Dr Alice Roberts Really?

Dr Shahrad Taheri in the test.

Dr Alice Roberts And when it comes to my appetite, there are more surprises in store. When you were sleeping your usual hours,you were eating about 1,700-1,800 calories. But when you were sleep deprived, I'm quite amazed, because I didn't expect this to happen so quickly, is that your intake went unto 2,000 calories.

Dr Alice Roberts So, just two nights' sleep deprivation has not only affected my mental powers, it's also had an impact on my calorie intake. The results are in line with larger-scale studies which show a link between persistent lack of sleep and obesity.

So, we find out about the effects of sleep on the brain. But also very interestingly, on appetite as well.And as for me, I'm off home to get nighty-night.

Resting the brain is important. And so is protecting it from injury. While Sean's love of rugby benefits his brain by keeping the blood vessel supplying it with oxygen healthy, the knocks to the head he's getting are not. Recent studies have suggested that playing a sport were you regularly suffer blows to the head could make you three times more likely to develop Alzheimer's.To protect it from injury,the soft, vulnerable brain is encased in a thick, hard skull. But the tight fit can also prove to be the brain's downfall.

This MRI scan shows just snug a fit it is for the brain inside the skull. You can see the edge of the brain here and then, this is the skull just around the outside. There's a little bit of room between the brain and the skull. But not much.

If anything else starts to take up room in the skull, like a tumour or a bleed, the increased pressure within the skull can have dire consequences.

79-year-old Peggy Crowley has been admitted to King's College Hospital in London after a stroke caused by a massive bleed in her brain. Surgeon Sanj Bassi must remove the clot as soon as possible.

Mr Sanj Bassi She's had a CT scan which shows a large blood clot on the right side of her brain.Probably the size of a small tangerine and what that's doing is pushing on the brain. She is just talking, but it's incoherent. She's moving her right arm to some degree. There's no movement on the left and my worry's left alone,she'll go into a deeper coma and she's unlikely to pull through from that.

Dr Alice Roberts Peggy collapsed while out shopping and was initially taken to Lewisham Hospital where as a young woman, she'd worked as a nurse. For husband Kevin and daughter Margeret, it's an anxious wait.

Margaret In my mind, I was really quite worried about whether she'd last the night. We were very worried and obviously very upset.

Kevin She is the centre of the family, isn't she?

Margaret She is. She's the heart of it. The heart of our family.

Mr Sanj Bassi Cut down through the scalp...

Dr Alice Roberts The life-saving operation to remove the clot will take up to two hours. The bleed is on the right side of the brain which controls the left side of the body. This is why it's Peggy's left arm and leg which have been paralysed.

Mr Sanj Bassi OK, drill please. Drill a hole through.

Dr Alice Roberts The skull over this part of the brain is more than half a centimetre thick.

Mr Sanj Bassi This drill actually contains a clutch-and-gear mechanism. So, when it gets to the solid bone, it cuts out.

Dr Alice Roberts Mr Bassi needs to create a large enough opening to be able to remove the clot. After drilling through the skull, he must cut through the thick, outer membrane - the dura mater - which also helpsto protect the brain.

Mr Sanj Bassi And there we see...the black is the blood coming out. What we can actually see here is normal brain - very small part of it, with the yellowy colour, and then the black is the blood clot itself and the brain's bulging up with the very high pressure. What we'll do now is go into that,try to evacuate it.

Dr Alice Roberts Peggy has a heart condition and has been on medication to thin her blood which the initial bleed worse. Eventually, the body's natural clotting mechanism kicked in but not before the escaped blood had formed a large clot. An hour into the operation, and Mr Bassi removes the last piece.

Mr Sanj Bassi The brain which initially was bulging out through our opening from the dura has now settled down. And also, the brain actually is pulsating which it wasn't doing as the pressure was high. Which shows the blood's getting back into the brain and we hope that part of the brain would now have a chance of surviving.

Dr Alice Roberts The pulsating brain is a good sign. But it's too soon to say whether any nerve cells have suffered permanent damage.

Two hours after the operation, Peggy is coming round in the High Dependency Unit. But the left side of her body remains paralysed. It will be several days before the doctors will know if she'll make a full recovery.

Peggy had no choice about the damage to her brain.Sean does. His GP has advised him that, although a brain scan hasn't shown up any abnormality, he should consider giving up rugby. It leaves Sean with a dilemma.

Sean One day I might get knocked up and not wake back up again. I know the consequences of that. I know that being knocked out has affected my memory, has affected my speech slightly. I know all this and I still play. I'm just conscious that if I stop playing rugby now at 27,I'd think when I'm 35-40,if only I carried on playing rugby, what would happen? So, I don't want to do the'If only'. That's why I still play.

Dr Alice Roberts A fortnight after her operation, Peggy has made remarkable progress. As well as recovering her speech, she's regained much of the movement on her left side.

Margaret Lift your arm up there. Lift both your arms up, Mum. Can you lift both your legs up? I think I can.

Peggy Yeah,

Margaret So you can move everything?

Peggy Yes

Dr Alice Roberts It's a tribute to the resilience of the brain and the skill of the surgeons. It's been a fascinating journey looking at this most complex of organs. There's still a lot more to find out about the brain.

But we've seen some of the ways that neuroscientists are doing just that. And when it comes to looking after our brain, a good night's sleep is essential and so is keeping physically active.

For Sean, the dilemma remains how to continue playing rugby while avoiding concussions. But there are techniques he can use to improve his recall.

And keeping mentally active seems to be the key to maintaining your memory into old age.